This 2003 electron microscopic (EM) image depicted a monkeypox virion, obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was a thin section image from of a human skin sample. On the left were mature, oval-shaped virus particles, and on the right were the crescents, and spherical particles of immature virions. (Cynthia S. Goldsmith/Russell Regnery/CDC via Bay City News)

Santa Clara County said Tuesday that it has expanded eligibility for the monkeypox vaccine, making it available by appointment to people who meet certain criteria.

Before this week, the county had only made the vaccine available via invitation due to a lack of supply. The county of 1.9 million people, as of 2020, has only received roughly 1,600 doses of the Jynneos vaccine for smallpox and monkeypox as of Tuesday.

County residents can make an appointment for the vaccine if they have had direct contact with someone who is confirmed to have contracted monkeypox or if they are gay, bisexual or otherwise attracted to men and have a recent history of multiple sexual partners, participate in group sex, have had a bacterial sexually transmitted infection like chlamydia or syphilis in the past year or perform sex work.

“This approach prioritizes vaccinating people who are at highest risk first,” said Dr. George Han, the deputy health officer with the county’s Public Health Department. “We have partnered with LGBTQ+ community organizations, who are an important part of local response to monkeypox, and we are grateful for their leadership and honored by their collaboration with us.”

Monkeypox is generally spread through skin-to-skin contact or bodily fluids via kissing, breathing at close range, sexual activity and sharing bedding or clothing. Health officials have stressed that the virus is not airborne like COVID-19 or the flu.

Symptoms can include a rash or sores on the skin anywhere on a patient’s body. Contraction of the virus often begins with flu-like symptoms as well.

The virus has been confirmed globally in many men who identify as gay or bisexual, but public health officials have stressed that the virus is not exclusive to men who are attracted to men and anyone can contract monkeypox via close contact with an infected person.

As of Tuesday, the virus has been confirmed in 23 county residents. According to the California Department of Public Health, 250 monkeypox cases have been confirmed statewide as of Thursday.

“As has been the case across the country, more vaccine is needed from the federal government supply to meet local demand as more individuals test positive and vaccine eligibility expands over time to everyone who needs it,” Han said.